Antillean Media Group

How prepared is the Caribbean for Ebola?

NEW YORK, New York, October 5, 2014 (AMG) – The recent diagnosis of Ebola in the United States has sparked the realization that the disease’s risk to the Caribbean is now much closer than ever before. And while some regional governments have assured citizens of their readiness to cope with any suspected cases of the virus, others are not so optimistic.

The Caribbean Public Health Agency (CARPHA), based in Trinidad, stated that along with Chikungunya control, preparation for eventual Ebola virus cases is among its “top public health priorities” in the Caribbean region.

Executive Director of CARPHA, Dr. James Hospedales, said “there is no room for complacency, and we at CARPHA continue to work with all our member states and our partners to bolster preparedness for Ebola, protect the health of people and implement measures to minimise risk.”

St. Vincent & the Grenadines was the first island to report a possible Ebola scare in September, when four Nigerian students headed to universities there had failed to provide medical certificates clearing them of the disease. None of the students eventually showed signs of illness, but they were quarantined as a precautionary measure to observe any possible symptoms.

On September 1, St. Vincent’s Ministry of Health announced that it was prohibiting entry of persons travelling from Liberia, Sierra Leone and Guinea, and any travellers who visited those countries within 28 days of arriving in St. Vincent. As previously reported, Liberia, Sierra Leone and Guinea have had the largest reported cases and deaths caused by Ebola in West Africa since the outbreak began in March of this year.

Further, passengers arriving from Nigeria, or any other West African country, are required to present medical proof that they have tested negative for the Ebola virus. Medical tests must be dated no later than a week prior to passengers’ departure from their country of origin.

Healthcare workers in Jamaica, primarily those at the University Hospital of the West Indies (UHWI), have expressed concerns about the lack of necessary equipment to deal with the Ebola virus. Their fears were underscored by Dr. Fenton Ferguson, Jamaica’s Minister of Health, who readily admitted that the island wasn’t “fully prepared” to deal with an occurrence of Ebola.

In response, the Pan-American Health Organization (PAHO) and some CARICOM countries have committed to assist Jamaica in its Ebola preparedness by providing the island with Personal Protection Equipment (PPE) for health care workers.

Acting Permanent Secretary in Jamaica’s Ministry of Health, Dr. Kevin Harvey, said that “PAHO has confirmed support for the provision of PPEs from its warehouse in Panama. If the need arises in Jamaica, items can be made available within 24 hours of notification of a case.” Dr. Harvey also said that the Ministry is in talks with the United States Government for additional PPE provisions.

To further the island’s preparedness, Immigration and Customs officers at Jamaica’s two international airports will be trained in detecting and assessing passengers who may have been exposed to Ebola. Dr. Marion Bullock Ducasse, acting Chief Medical Officer (CMO), said that training will commence on October 6 at the Norman Manley International Airport. Dr. Bullock Ducasse noted that “the training will include, but will not be limited to, applying more scrutiny and assessment of people’s travel history […], information on the Ebola virus itself and how to protect themselves.”

In Grenada, preventative measures are also being taken. Minister of Health, Dr. Clarice Modeste-Curwen, said that authorities have assigned areas in the airport for isolation of any possible Ebola patients, and have also designated locations in the Grenada General Hospital for any such persons.

Dr. Modeste-Curwen assures Grenadians that the Ministry has and will be following World Health Organisation (WHO) and PAHO guidelines regarding precautions for dealing with Ebola patients. She further stated that the Ministry is in possession of a few hundred protective suits which are being distributed to “first contact” areas on the island. The Ministry is also preparing to have a ‘dry run’ with health workers on the island to increase their preparedness in the event that an Ebola patient should arrive.

Meanwhile, in St. Lucia, Dr. Sharon Belmar-George, Senior Medical Officer in the Ministry of Health expressed the island’s improving readiness to respond to a possible Ebola threat, using a regional and international approved approach. This includes educating and sensitising both health and non-health workers on the island. In addition, all major health institutions have been designated with isolation rooms, and surveillance has increased at various ports of entry for visitors with a travel history to Ebola-affected countries.

In Barbados, however, there seems to be division in the confidence of the Ministry of Health. Acting Minister of Health, Donville Inniss, said that the Barbados Government is being proactive and aggressive in its preparation for dealing with suspected Ebola cases. However, the head of the Barbados Association of Medical Practitioners, Dr. Carlos Chase, said that he was “not impressed with the level of preparedness” following a meeting with the Ministry of Health three weeks ago.

The Ministry of Health responded to Dr. Chase’s concerns, detailing its comprehensive measures to deal with the disease, which include: heightened surveillance at ports of entry, and sensitisation of Immigration and Customs Officers; upgrading of quarantine facilities at the ports of entry; development and dissemination of a procedural manual on Ebola to healthcare providers; intensive hands-on training of healthcare providers; establishment of an Isolation Unit on the grounds of the Queen Elizabeth Hospital; and verification of the stock levels of personal protective equipment, including body suits.

The Caribbean still remains without any cases of the Ebola virus. CARPHA, its member states, the CARICOM Secretariat and PAHO maintain their commitment to working together to minimize the region’s risk of local transmission of the disease, and strengthening their abilities to respond to any potential imported case.

Travel restrictions

In the region, as Health Ministries focus on preparing their staff to deal with Ebola patients, country leaders have decided to place immediate bans on travellers coming from the West African countries that have been hit the hardest by Ebola, i.e. Liberia, Sierra Leone and Guinea.

Islands with restrictions on passengers travelling directly or indirectly from West Africa are: St. Vincent and the Grenadines, Trinidad and Tobago, Jamaica, St. Lucia and St. Kitts and Nevis

In Trinidad, citizens who have visited Ebola stricken countries will be quarantined for 21 days. A similar ‘landing restriction’ will also be placed on Jamaican citizens travelling home from West Africa.

Guyana’s Health Minister, Dr. Bheri Ramsaran, has said that while there are strict restrictions on the entry of passengers from the three West African countries, an explicit ban has not been imposed – however, these passengers will be ‘carefully evaluated’ before they are granted permission to enter the country.

The Minister of Health in Barbados, John Boyce, stated “we have not taken a recommendation of banning travel at this stage so this is something which we have to consider and I will have to engage the team at the Ministry [of Health] before we arrive at [a decision] like that.”

Dr. Delon Brennen, Chief Medical Officer in The Bahamas said “we know that it is almost impossible to prevent that one case from entering into your borders,” but that the Ministry of Health was working diligently to train health workers and other personnel at various ports of entry on protocols in dealing with potential Ebola patients.

The Government of Grenada has not yet made any announcements regarding West African passengers, but says that they were considering imposing a similar ban.

On October 20th, Havana, Cuba will be hosting a Regional Summit on Ebola focusing on the prevention and fight against Ebola. The Havana Summit will also establish joint efforts to prevent the spread of Ebola in the Latin America and Caribbean region. Cuba is currently leading the response to Ebola in West Africa and was recently ‘welcomed’ to support the U.S. in containing the spread of the virus.

Since this story broke on October 5th, some Caribbean leaders have takenfurther preventative measuresto circumvent a possible outbreak of the virus in the region. With a death toll of over 4500 in West Africa, the Ebola virus has created worldwide trepidation. After the first Ebola patient, Thomas Duncan, was diagnosed and later died from the virus in Texas, two health care workers who cared for Duncan have been diagnosed with Ebola. In Spain, another health care worker who tended to an Ebola patient has also been diagnosed.

How prepared is the Caribbean for Ebola?

Sophia is a Grenadian residing in the United States. She holds an MPH and an MSc. in Natural Resource and Environmental Management, and has research interests in the impact of the environment on public health.

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